VERIFICATION OF BLOOD COLLECTION SYSTEM GIAN LUCA SALVAGNO, MD, PhD University of Verona, Italy.

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Presentation transcript:

VERIFICATION OF BLOOD COLLECTION SYSTEM GIAN LUCA SALVAGNO, MD, PhD University of Verona, Italy

HUB Spoke START

Laboratory’ s errors Lundberg’s loop.

Laboratory testing

Errors and patient’s outcome

Pre- analytica l errors

Preanalytical:56% Analytical:21% Postanalytical:18% Multiple: 5% Preanalytical:56% Analytical:21% Postanalytical:18% Multiple: 5% ……….and in laboratory?

Pre-analytical phase: Where? Patient identification Critical s point Blood specimen collection Specimen identification Specimen transport Time of specimen arrival Check-in Centrifugation decaping Aliquoting and labeling of the secondary specimen Outside LaboratoryLaboratoryLaboratoryLaboratory Within

Phlebotomist?

Blood collection device

Blood drawing technique

VENOUS STASIS

Venous Stasis:Tourniquet time

1)Tourniquet time: Clinical Chemistry

GLS 2) Tourniquet time: Coagulation testing

3) Tourniquet time: Hematological testing

BLOOD CONTAINER

GLS Anticoagulants

VENOUS ACCESS

Hemolysis: Clinical Chemistry

GLS Hemolysis: Coaguation testing

GLS VisuallyundetectablehemolysisVisuallyundetectablehemolysis Percentage RBC lysate on the total RBC mass Hemolysis :clinical chemistry testing

NEEDLE SIZE

Recommendations for Collection of a Quality Specimen for Coagulation Testing

Influence of under-filling of 3.2% buffered sodium citrate blood tubes on results of activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen, activated protein C resistance (APCR), and coagulation factor VIII. The dotted lines designate the desirable bias for each parameter.

GLS The JCAHO has recently given priority within the 2007 National Patient Safety Goals to the improvement of the accuracy of patient identification and it applies to all JCAHO-accredited healthcare organizations and those seeking JCAHO accreditation. Failure to comply can result in a special Type I recommendation and jeopardize a facility’s accreditation status.

GLS The International Organization for Standardization 15189:2003 clause 5.4 “Pre-examination procedures'” includes requirements for traceability of primary samples to an identified individual.

GLS

What’s next?

“Which is the best choice?” Or……

…and I am ready to start!

The End Take a home message